Basic Information
| Provider Information | |||||||||
| NPI: | 1467707331 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTA BARBARA COUNTY DEPARTMENT OF BEHAVIORAL WELLNESS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | AB 109-SM | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 CAMINO DEL REMEDIO | ||||||||
| Address2: | SUITE 257 | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931101332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056815220 | ||||||||
| FaxNumber: | 8056815262 | ||||||||
| Practice Location | |||||||||
| Address1: | 124 CARMEN LN | ||||||||
| Address2: | SUITE K | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934587768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053467620 | ||||||||
| FaxNumber: | 8053467621 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2012 | ||||||||
| LastUpdateDate: | 08/23/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | CASIANO | ||||||||
| AuthorizedOfficialFirstName: | TAMMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | QCM COORDINATOR/DESIGNEE | ||||||||
| AuthorizedOfficialTelephone: | 8053255905 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SB CTY DEPT OF BEHAVIORAL WELLNESS | ||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
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| AuthorizedOfficialCredential: | LMFT | ||||||||
| NPICertificationDate: | 08/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.